Pooled analysis of prospective cohort studies of associations of tumor vascular features with colorectal cancer-specific mortality

The phenotypic and morphologic heterogeneity of tumor vasculature in colorectal cancer (CRC) has been increasingly recognized; however, its clinical importance remains unclear. Pooled analysis of data from the Nurses’ Health Study and the Health Professionals Follow-up study examined whether specific tumor vascular features are associated with CRC-specific mortality. Tumor vessels were successfully analyzed in 837 patients with CRC (median age at diagnosis 69 years; IQR 63-75; 56% female). During a median follow-up of 11.8 years (IQR 8.7-14.7) there were 628 all-cause deaths, including 263 CRC-specific deaths. The figure shows CRC-specific survival according to vascular metrics. Higher overall CD34⁺ vessel density and microvessel proportion were associated with lower CRC-specific mortality, whereas CD34⁺CD36⁺ and CD34⁺LAMB1⁺ vessel proportions were associated with higher mortality. The authors conclude that these findings suggest that tumor vascular features in CRC likely reflect biologically distinct tumor microenvironment and may serve as prognostic biomarkers.